The Long-Term Prognostic Role of Nighttime Resting Heart Rate in Obstructive Sleep Apnea in Patients with Acute Coronary Syndrome

DOI Web Site PubMed 参考文献38件
  • Xin Qingjie
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Ai Hui
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Gong Wei
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Zheng Wen
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Wang Xiao
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Yan Yan
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Que Bin
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Li Siyi
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Zhang Zekun
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Chen Xiuhuan
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Zhou Yun
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Fan Jingyao
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases
  • Nie Shaoping
    Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University National Clinical Research Center for Cardiovascular Diseases, Beijing, China Beijing Institute of Heart, Lung, and Blood Vessel Diseases

抄録

<p> Aim: A close relationship exists between resting heart rate (RHR) and obstructive sleep apnea (OSA). Still, the prognostic importance of nighttime RHR in patients with acute coronary syndrome (ACS) with or without OSA remains unclear.</p><p>Methods: In this prospective cohort study, OSA was defined as an apnea–hypopnea index of ≥ 15 events/h, and the high nighttime RHR (HNRHR) was defined as a heart rate of ≥ 70 bpm. The primary endpoint was a major adverse cardiovascular and cerebrovascular event (MACCE), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for heart failure.</p><p> Results: Among the 1875 enrolled patients, the mean patient age was 56.3±10.5 years, 978 (52.2%) had OSA, and 425 (22.7%) were in HNRHR. The proportion of patients with HNRHR is higher in the OSA population than in the non-OSA population (26.5% vs. 18.5%; P＜0.001). During 2.9 (1.5, 3.5) years of follow-up, HNRHR was associated with an increased risk of MACCE in patients with OSA (adjusted HR: 1.56, 95% CI: 1.09–2.23, P=0.014), but not in patients without OSA (adjust HR: 1.13, 95% CI: 0.69–1.84, P=0.63).</p><p>Conclusions: In patients with ACS, a nighttime RHR of ≥ 70 bpm was associated with a higher risk of MACCE in those with OSA but not in those without it. This identifies a potential high-risk subgroup where heart rate may interact with the prognosis of OSA. Further research is needed to determine causative relationships and confirm whether heart rate control impacts cardiovascular outcomes in patients with ACS-OSA.</p>

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